Homestead_Hamm`r r
Gibson County dito v
101 N Main Street
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a ee Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
f 1M _Rrinceton, IN 47670 more beneficial, there is more incentive than ever for homestead fraud. Homestead (mud muses higher tax bills for all; therefore.
n R t/ , HEA 1344 -2009 requires tacpaym who receive the homestead standard deduction to verify that they are eligible to receive the
® l.V �� benefit and to provide additional idrnlifiing in(ormalion necessary W allow county government to better monitor homestead
F y' filings. This information will be kept confidential and can only be accessed by authorized county officials. The Depvnnrn[ of
Ill Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
1 1
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MAY � 2011 Taxpayer Name Location Address
/ Nelson, Dorothy L Etal
200 CENTER DR
v w\ OAKLAND CITY IN 47660
56WSON COUNTY AUDITOR
Justin MHamm II1111111111 Hill 1111111III1111J1IIIIII111111III IIIIVII11illi illillilli
200 Center Dr
OAKLAND CITY IN 47660 -8974
IIIII�IIIIIIII�lllllll��r�Ill�ttl�Illtllltili�tttll�llllil�lll�l� State Parcel Number Legal Description
26- 14 -18- 102 - 000.392 -007 /MARION HEIGHTS 15
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
- PART 2: TAXII'AI'ER INFORiNlivi
10
G t First
Middle
Last
U 1, rL
Mailing Address (number and street, city, state, and ZIP code)
Same as property address
aoo , 'V oa -z
76, i�eo
Social Security Number past s digits)
Drivels License/State ID Number past 5 digits)
Middle Last
(,j ern n 6
tod,ie,
>yQm
Mailing Address (Number and street city- state, and ZIP code)
e'&
Same as property address
aoo rl- ve Dakla .
LV
Social Security Number (last 5 digits) Drivers License /State ID Number (last 5 (Wits) Other (please specify in Pan 4 below)
=s„r
Each undersigned certifies, under penalty of perjury, that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also
understands that, by claiming additional homestead deductions
unlawfully, he or she tr�aayy be liable for bacy taxes and substantial financial penalties.
Owner I Signature /j
Date
Telephone
(
)